Professor Zhang Maoping’s Academic Thought And Clinical Research In The Treatment Of Diabetic Nephropathy Experience

Objective:Diabetic nephropathy is a world problem. Traditional Chinese medicine can effectively improve urinary protein excretion and delay the renal damage in patients with diabetic nephropathy.Chinese medicine early diagnosis and treatment of diabetic nephropathy can delay the progress of renal damage in patients with diabetic nephropathy. This research focuses on the country’s fifth batch of famous TCM expert Professor Zhangmao Ping’s "Drug Xin Wen opened Xuanfu, collaterals" theory as the core,the traceability and finishing Zhangmao Ping teacher"Opened Xuanfu, Nutrition collaterals, wind drug especially wonderfuno leave Xin and Wen, summarizes"," from the ’Sim’s treatment of renal edema, to ’pass’ for the use of " academic thought and a lot of clinical experience.In order to provide theoretical basis and new treatments for Diabetic nephropathy diseases.Methods:1.Learning through inheriting the teacher, system review four classic and widely read ancient books related to this professional, traced back, system elaborated Zhang Maoping teacher academic thought theory origin.2.With outpatient, face-to-face teaching, independent clinical practice, writing comments monthly, reading classics and works of various genres, concentrated study methods such as system Mining, summarizes the teacher unique academic thought and extensive clinical experience Through summarizing the experience, improve their theoretical level and adjust our skills, and put forward their own original ideas, improve their ability of clinical scientific research.3. In the form of clinical subject to research the teacher unique academic experience.Content:1. Research Professor Zhangmao Ping excavations "Drug Xin Wen opened Xuanfu, collaterals" academic theory and ideological origins and diabetic nephropathySummary Zhangmao Ping teacher "Opened Xuanfu, Nutrition collaterals, wind drug especially wonderfuno leave Xin and Wen, summarizes"," from the ’Sim’s treatment of renal edema, to ’pass’ for the use of" academic thought, is the source Liu Hejian Xuanfu in theory, Ye Tianshi collateral disease theory, "Su asked the dirty air law":the "dry kidney pain, acute food Xin to run it".Kidney deficiency leads to dry because the water can not be gasified liquid, liquid water can not spread themselves,Pungent drugs can make smooth air-water liquid operating normally, dissipate Hanxie moisten their role.In recent years, a number of basic and clinical studies suggest that apoptosis is involved in the pathogenesis of early diabetic nephropathy, but now for a different way of programmed cell death in cells significance in the pathogenesis of diabetic nephropathy is not clear. Autophagy is one of the way of programmed cell death, is the deficiency of vital qi under the way of self-help. It is through the timely transformation, elimination of endogenous real evil (such as phlegm and blood stasis etc.) (Yin) to generate energy for the body to use the new material (Yang), the dynamic balance of yin and Yang, to ensure the normal function of cells. However, the relationship between autophagy and the development of diabetic nephropathy and the role of important intermediate molecules in the pathogenesis of diabetic nephropathy is not clear.Chinese medicine field pathogenesis of diabetic nephropathy also raised awareness of kidney and blood stasis, kidney network stasis, phlegm, toxic damage of kidney.But no in-depth study of the relationship between stasis and Xuanfu of collaterals.2. Organizing and researching the professor Zhangmao Ping "Drug Xin Wen opened Xuanfu, collaterals" theory academic thoughts and clinical experience.Discuss diabetic nephropathy from the collaterals, Xuanfu. "Collaterals" are small channels that spread in the body’s essence, gas, blood, body fluid circulations while "Xuanfu" are holes on the "collaterals", and both are open if not obstructed. The essence of Collaterals"may have a correlation with the western medicine in the capillary microcirculation, The essence of Xuanfu might be related with western medicine in cell membrane, various channels of ion, sugar and other relevant channels. Zhang proposed Xuanfu is the material basis for organizational structure of the kidney, The glomerular capillary is kidney collaterals, Kidney sieve for kidney Cou, and Xuanfu,access road of blood and body fluids of the kidney,.Xuanfu Rong Rong collaterals; Xuanfu closed, collaterals closed. Diabetes because of the heat and dry hurt Yin Ye, Xuanfu dystrophy Xuanfu opene and close loss Secretary, Long-term high-sugar, water stasis each knot, clogging the fine structure of Xuanfu channel,Shenluotong Blockage barrier.Treatment is based on the opening of Xuanfu and warming Yang. Zhang the division pointed out that Diabetic nephropathy is due to the spleen and kidney deficiency imaginary.Yang deficiency based, turbid stasis as the standard, spleen acquired the book, "If Pitu is strong, there is no wet; no wet no cancellation," kidney is the origin of congenital constitution, and the kidney controls the water metabolism, "if kidney and Yang are sufficient, there is no thirsty." According to diabetic nephropathy, Yang deficiency, liquid water stop together, dry,Xuanfu occlusion, collaterals arrest pathogenesis,treatment should be "clear the pathway," "unobstructed blood flow", and make use of drugs to relieve congestion, adjust Qi, dampness and phlegm, blood flow, and the is evil can be excreted. So Tonifying the kidney is the most important, Jinguishenqi, decoction ephedra,Asarum, Pinellia, Gui, Chuan Xiong, etc are usually used to inspires human gasification function, clear the camp blood disorder caused by blood disorders, and thereby improving the Zang-Fu organs and lose the "dry" syndrome. It has a unique function that other general huoxue drugs can not replace, and the frequent use can make the blood circulation effect significantly enhanced. For more complex virtual pass fill, Yiqiwenyang drugs, such as ginseng, astragalus, aconite, cinnamon, cassia twig, etc. should be used often.Treatment of renal edema focused on the opening of Xuanfu, dredge.Kidneys water presides over the water metabolism of the body. Adequate Kidney Yang, Yang metaplasia gas, will not make people suffer from edema, Zhang considers chronic illness affects kidney, kidney failure, no right gasification, water kinky Xuanfu triple burner Yongzhi, Based on "should be kept collaterals to open" principle,Upper and lower sub-elimination, repair Xuanfu opening and closing function. General prescriptions should often include red bean soup ephedra forsythia, more handmaiden soup together Mahuangfuzixixin soup, real Wu Wuling mixture, Jinguishenqi Dangguisini together Evodia soup, Commonly used drug are ephedra, Asarum, Chai Hu, which open collaterals, aconite, ginger, Gui, which warming Yang and water, and warm meridians, astragalus, dogwood, gelatin, which nourish kidney and Rong Yang collaterals.Experimental studies conducted in a rat model of diabetic nephropathy autophagy state National Natural Science Foundation of China Tiwil ^ gene transfection changed. The correlation between autophagy and traditional Chinese medicine theory, Chinese intervention mechanism of cell autophagy, etc., from the perspective of animal experiments to verify the "Onyang tonic" theory of scientific treatment of diabetic nephropathy.Author Based on the theory of warming Yang to remove obstruction to open black water, great attention should be paid to smoothing the liver and blood, because the blood does not profit meridians open water. Based on water and soil, tonifying the kidney, strengthening the spleen helps to treat diabetic nephropathy in tune on your liver, Jue chilly wind wood Liver dispersion, the main reservoir of blood, wind-driven consumption of liquid, injury of blood, leading to liver lung and stomach heat Sheng, Zhuang fire eclipse gas, fluid gas two injuries, so the treatment of diabetic nephropathy. It should also take into account the regulation of liver function, thereby delaying the course, receive better treatment. On the basis of instructors with visceral disease drug treatment wind on the lookout to expand the drug limb disorders, back pain treatment proposed network, the wind drug was this view.3. Designed and implemented the opening Xuanfu oct drug evaluation research Wenyang Rong Yang dredge collaterals of Diabetic nephropathy clinical efficacy of early and mid. According to the diagnosis of the inclusion and exclusion criteria, selection of diabetic nephropathy in line with credit to Yang Qi and blood stasis in 60 cases according to 1:1 were randomly divided into two groups (combination of Group) and control group (treatment group) randomized, controlled trials, in the treatment group with astragalus with kidney pills, red peony, Polyporus, ephedra.Classification of symptom scores, combined with biochemical markers (Cys-c and the CRP, BUN, and SCr, BS, 24TP, etc), Verify that "Drug Xin Wen opened Xuanfu, collaterals" effect. Conclusion:1.which initiates a preliminary exploration of the relationship between the kidney essence of traditional Chinese medicine and " Xuanfu-Kidney collaterals-renal microcirculation" "Xuanfu opening and closing loss Secretary-Kidney collaterals water metabolism disorders".2.Diabetic nephropathy and chronic illness hurt yang, and water and stasis are Yinxie, drug treatment should be warm.3.The treatment of refractory renal edema:"Xin taste of drugs opened Xuanfu, Tom Lee triple burner" to " Unobstructed".Kidneys water presides over the water metabolism of the body.4.Experimental studies have shown that:Autophagy deficiency may promote the development of diabetic nephropathy,In conclusion, the Tiwil 2 mRNA transfection could obviously enhance the autophagy biomarker, including Beclin 1 and LC3 protein, ZLHXTY attenuates many pathologic changes in kidney structure and function associated with diabetes in rats. It plays a renoprotective role, possibly by sustaining mitochondrial function through the ROCK1-Drp1 pathway.5.Clinical studies have shown that early and middle diabetic nephropathy patients should use Huoxuetongluo Kidney at early times, Recipe ginseng, astragalus with kidney pills, red peony, Polyporus, ephedra. It may reduce urinary excretion of protein, and promote the elimination of edema, relieve symptoms and improve kidney function and delay disease progression.